Male Infertility – A Doctor Q & A

Infertility is a common problem, affecting approximately 8-10% of couples; with the problem often stemming from issues related to the male partner and sperm production. Below we outline some of the major causes for male infertility and how these can be diagnosed and addressed by your specialist.

Q – What is the biggest obstacle when it comes to addressing male infertility factors with patients?

Accordingly, many of the couples who seek care at fertility offices will often assume that the reason they have been unable to conceive is due to an issue related to the female partner. So when an office evaluation reveals that the source of the fertility issues is due to a male component, many of the male partners are understandably shocked and perplexed. It will often take some time for an individual to come to terms with this and it is the responsibility of the provider to make sure that the couples’ concerns and questions are adequately addressed.  The remainder of patients we generally categorize as “unexplained” or a combination of male and female factors.

Q – What is the most common form of Male Infertility that fertility specialists see?

The most common form of male factor infertility (MFI) that we see is idiopathic, meaning that there is no clear identifiable factor leading to a decrease in sperm quality. The second most common type of MFI that we see are disorders related to defects in sperm production at the level of the testes, which can be due to a number of diseases. Less common issues are disorders of sperm transport and diseases of the brain that alter hormonal signaling to the testes, thus lowering sperm production.

Fertility specialists will generally order several blood tests to determine male hormone levels and to see if there may be a genetic cause for the issue. A detailed history will be taken to assess if the male partner has had any exposure to particular infections (e.g. mumps) or environmental factors (e.g. pesticides) that are known to decrease sperm production. Lastly, an ultrasound of the testes/scrotum may be warranted.

Q – What (if any) dietary interventions do you recommend for Male Infertility? What pharmaceutical and/or dietary supplement protocols are most successful?

Some studies have shown that eating a more well-balanced diet (with less processed foods) may improve sperm parameters. I recommend that patients avoid foods that are known to be unhealthy, such as soda, sweets and fast food options. Environmental and lifestyle factors may be the reason for the high levels of oxidative stress on the body. Supplementing with certain antioxidants (such as vitamins A & E, L-carnitine, N-acetylcysteine) may improve pregnancy rates but the research has mixed results. In some, but not all situations, these medications might be helpful to improve the sperm parameters.

Q – What is/are the most important thing(s) that patients dealing with Male Infertility should know?

If you are faced with the diagnosis of male factor infertility, please know that you are certainly not alone in this regard, and there are numerous support options available to you. In addition, the field of assisted reproductive technology (ART) has made many advances in recent decades and we are able to overcome many of the obstacles posed by male factor infertility.

It is important to seek care with a fertility specialist if you have been found to have a low sperm count and are planning on having children. Some patients are inappropriately counseled on their situation or receive sub optimal care due to a provider’s lack of knowledge in this particular area. Even patients with an extremely low sperm count can conceive using specialized procedures and techniques.

Q – Any additional information regarding the treatment of Male Infertility factors?

Fertility preservation prior to cancer treatment has become a more popular topic of conversation in recent years, particularly as the techniques for female egg freezing have improved. If you are faced with a diagnosis of cancer, remember to speak with your oncologist about sperm freezing (a.k.a. “sperm cryopreservation”) prior to starting any treatments. Certain treatments are harmful for developing sperm, such as chemotherapy and radiation treatment, and can impair sperm production in the future. Even if you are not currently interested in having children, your physician may recommend that you freeze sperm for future use, in the event that your cancer treatment has a detrimental effect on your fertility.

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